Pulse during collapse. Vascular collapse

One of acute forms vascular insufficiency is called collapse. He takes intermediate position between fainting and shock. It is characterized by a drop (collapse means fallen) pressure, dilation of veins and arteries with the accumulation of blood in them.

Occurs with infections, allergies, blood loss, insufficient functioning of the adrenal glands, or under the influence of strong antihypertensive drugs. Needed for treatment emergency hospitalization and administration of drugs that increase systemic pressure.

Read in this article

Causes of acute vascular collapse

The following can lead a patient to a collaptoid state:

sharp pain;
injuries;
blood loss, general dehydration;
acute infectious processes;
short cardiac output ( , );
severe allergic reactions;
intoxication due to internal (kidney, liver, intestinal diseases, acute inflammation) or external ( various poisonings) entry of toxic substances into the blood;
administration of drugs for general or spinal anesthesia, barbiturates, overdose of sleeping pills, narcotics, medications for the treatment of arrhythmia, hypertension;
decreased synthesis of catecholamines in the adrenal glands;
a drop in blood sugar or its sharp increase.

Determining the cause of collapse is not difficult if it occurs against the background of an existing disease. At sudden development it is the first manifestation of emergency conditions (for example, ectopic pregnancy, bleeding from a stomach ulcer). In older people, acute vascular insufficiency often accompanies myocardial infarction or pulmonary embolism.

Symptoms of deficiency

The first signs of collapse are sudden general weakness, yawning, dizziness. Then they quickly join:

When fainting, spasm of cerebral vessels occurs, and even with mild form patients lose consciousness. It is also important to distinguish collapse from shock. In the latter case, heart failure and severe metabolic processes And neurological disorders. It should be noted that the boundary between these conditions (fainting, collapse, shock) is often quite arbitrary; they can transform into each other as the underlying disease progresses.

Types of collapses

Depending on the causes and leading mechanism of development, several types of vascular collapse have been identified:

orthostatic– with a sharp change in body position in case of ineffective regulation of arterial tone (recovery from infections, taking antihypertensive drugs, rapid decrease in body temperature, pumping fluid from cavities, uncontrollable vomiting);
infectious– a decrease in arterial tone occurs under the influence of bacterial or viral toxins;
hypoxic– occurs when there is a lack of oxygen or low atmospheric pressure;
dehydration– it is caused by loss of fluid during severe infections with diarrhea and vomiting, excessive excretion of urine during forced diuresis, diabetes mellitus with high hyperglycemia, with internal or external bleeding;
cardiogenic– associated with myocardial damage during heart attack, cardiomyopathy;
sympathicotonic– blood loss or dehydration, neuroinfection, occurs with vascular spasm at normal pressure;
vagotonic– severe pain, stress, anaphylaxis, low blood sugar or lack of adrenal hormones. The sharp difference between , ;
paralytic– severe diabetes, infectious processes, depletion of compensation reserves, paralytic vasodilation with a sharp decrease in blood circulation.

According to the severity of the patient's condition, there are:

easy- pulse increases by a third, blood pressure increases lower limit normal, pulse (difference between systolic and diastolic) low;
moderate severity– heart rate increased by 50%, pressure about 80-60/60-50 mm Hg. Art., urine output decreases;
heavy– consciousness changes to a state of stupor, lethargy, pulse is increased by 80 - 90%, maximum pressure below 60 mm Hg. Art. or not determined, anuria, intestinal motility arrest.

Features of vascular insufficiency in children

IN childhood common cause collapse there are infections, dehydration, intoxication and oxygen starvation in diseases of the lungs, heart, nervous system.

Minor external influences can lead to vascular insufficiency in premature and weakened children. This is due to the physiological inferiority of the mechanisms regulating the tone of arteries and veins, the predominance of vagotonia, and the tendency to acidosis (a shift in the blood reaction to the acidic side) in this category of patients.

Signs of the onset of a collaptoid reaction are a deterioration in the child’s condition - against the background of the underlying disease, severe weakness, lethargy and even adynamia (low motor activity) appear.

There is chills, pale skin, cold hands and feet, increased heart rate, which becomes thread-like. Then the blood pressure decreases, the peripheral veins lose their tone, while maintaining consciousness, children lose their reaction to their surroundings, and convulsive syndrome is possible in newborns.

Emergency care before the ambulance arrives

Collapse can only be treated in a hospital, so you should call emergency help as quickly as possible. All the time before the doctor arrives, the patient must be in a horizontal position with his legs raised (place a blanket or clothes rolled up in a bolster).

It is necessary to ensure the supply fresh air– unfasten the collar, loosen the belt. If the attack occurred indoors, then you need to open the windows, while covering the victim with a warm blanket. Additionally, you can apply a warm heating pad or bottles of non-hot water to the sides of the body.

To improve peripheral circulation rub hands, feet, ears press into the hollow between the base of the nose and the upper lip. You should not try to sit the patient up or give him medications yourself, since the most common drugs (Corvalol, No-shpa, Validol, especially Nitroglycerin) can significantly worsen the condition and turn collapse into shock. For external bleeding, apply a tourniquet.

Watch the video about first aid for fainting and vascular collapse:

Medical therapy

Before transporting the patient to the hospital, the introduction of vasoconstrictors can be used - Cordiamine, Caffeine, Mezaton, Norepinephrine. If collapse occurs due to loss of fluid or blood, then administration similar drugs is carried out only after restoration of circulating blood volume using Reopoliglucin, Stabizol, Refortan or saline solutions.

In severe cases and in the absence peptic ulcer apply hormonal drugs(Dexamethasone, Prednisolone, Hydrocortisone).

Inhalation of humidified oxygen is indicated for patients with hypoxic collapse, poisoning carbon monoxide, severe infections. In case of intoxication it is carried out infusion therapy– administration of glucose, isotonic solution, vitamins. In case of bleeding, plasma substitutes are used.

Patients with heart failure additionally receive cardiac glycosides; in case of arrhythmia, it is necessary to restore the rhythm with the help of Cordarone, Atropine (for conduction block, bradycardia). If collapse develops against the background of a severe attack of angina or heart attack, then carried out intravenous administration antipsychotics and narcotic analgesics, anticoagulants.

Forecast

With the rapid elimination of the cause of the collapse, it is possible full recovery normal indicators hemodynamics and patient recovery without consequences. For infections and poisonings, adequate and timely therapy is also often quite effective.

The prognosis is more severe for patients with chronic, progressive diseases of the heart, digestive organs, and pathology of the endocrine system. In such patients, repeated, repeatedly recurrent collaptoid conditions are especially dangerous. Because of age characteristics The collapse of the body is most dangerous for children and the elderly.

Prevention

Prevention of acute vascular insufficiency consists of:

timely diagnosis and treatment of infections, intoxications, bleeding, burns;
taking strong medications to lower blood pressure only when medical advice, under the control of hemodynamic parameters;
correction of metabolic disorders;
maintaining recommended blood glucose levels.

At acute infections With high temperature body is important bed rest, slow transition to a vertical position, sufficient drinking regime, especially with fever, diarrhea and vomiting.

Collapse is an acute vascular failure, it occurs with infection, poisoning, blood loss, dehydration, heart disease, endocrine pathology. The difference from fainting is the absence of an initial loss of consciousness. Manifestations: decreased blood pressure, severe weakness, lethargy, pale and cold skin, sticky sweat.

It is difficult to tolerate in childhood and old age. Emergency assistance consists of placing the patient in a horizontal position, quickly calling a doctor, and providing access to fresh air. For treatment it is administered vasoconstrictors, hormones, infusion solutions and plasma expanders. Required condition favorable outcome is to eliminate the cause of the collapse.

ICD-10

R55 Fainting [syncope] and collapse

General information

Collaptoid state (vascular insufficiency) is a pathology that suddenly arises against the background of the presence of chronic or acute cardiovascular diseases. vascular system, other diseases. It is more often diagnosed in patients prone to hypotension, with myocardial infarction, total block of intracardiac conduction, and ventricular arrhythmias. The pathogenesis and clinical signs resemble shock. It differs from it in the absence of characteristic pathophysiological phenomena in initial stages– changes in pH, significant impairment of tissue perfusion and disruption of function internal organs are not detected. The duration of collapse usually does not exceed 1 hour, state of shock may persist for a longer period of time.

Causes of collapse

Regulation of vascular tone is carried out using three mechanisms: local, humoral and nervous. Nervous mechanism consists of stimulating the vessel wall with fibers of the sympathetic and parasympathetic nervous system. The humoral method is realized due to sodium and calcium ions, vasopressor hormones (adrenaline, vasopressin, aldosterone). Local regulation involves the appearance of foci of ectopia directly in the vascular wall, the cells of which have the ability to generate their own electrical impulses. Blood network skeletal muscles regulated primarily in a nervous way Therefore, the causes of collapse can be any condition in which the activity of the vasomotor center of the brain is suppressed. The main etiofactors are:

Infectious processes. Lead to the development of vascular insufficiency severe infections accompanied by severe intoxication. Collapse most often occurs when lobar pneumonia, sepsis, peritonitis, meningitis and meningoencephalitis, typhoid fever, focal inflammatory diseases CNS (brain abscess).
Exogenous intoxications. Pathology is detected in case of poisoning with organophosphorus compounds, carbon monoxide, and drugs that can affect vascular tone (clonidine, capoten, ebrantil). In addition, collapse can develop under the influence of local anesthetic drugs when administered epidurally or peridurally.
Heart diseases. The most common reason is acute heart attack myocardium. Collaptoid conditions can also be detected against the background of cardiac malformations, decreased myocardial contractility, tachy- or bradyarrhythmia, dysfunction of the sinoatrial node (pacemaker), failure of the atrioventricular connection (3rd degree AV block) with discoordination of the atria and ventricles.
Injuries. The main cause of vascular insufficiency in trauma is a large amount of blood loss. In this case, there is not a relative, but an actual decrease in BCC due to physical loss of fluid. In the absence of profuse hemorrhage, a drop in vascular tone becomes a reaction to severe pain, which is more common in children and patients with high tactile sensitivity.

Pathogenesis

The pathogenesis of collaptoid states is based on a pronounced discrepancy in throughput vascular network and OCC. Dilated arteries do not create the necessary resistance, which leads to sharp decline HELL. The phenomenon may occur when toxic damage vasomotor center, disruption of the receptor apparatus of large arteries and veins, inability of the heart to provide the required volume of blood ejection, insufficient quantities fluids in the circulatory system. Fall blood pressure leads to a weakening of gas perfusion in tissues, insufficient oxygen supply to cells, ischemia of the brain and internal organs due to a mismatch between the metabolic needs of the body and the level of its O2 supply.

Classification

The division is made according to the etiological principle. There are 14 types of collapse: infectious-toxic, pancreatic, cardiogenic, hemorrhagic, etc. Since the same first aid measures are carried out for all types of pathology, such a classification has no significant practical significance. Systematization by stages of development is more relevant:

Sympathotonic stage. Compensatory reactions are expressed. There is a spasm of small capillaries, centralization of blood circulation, and the release of catecholamines. Blood pressure remains normal or rises slightly. The duration does not exceed several minutes, so the pathology is rarely diagnosed at this stage.
Vagotonic stage. Partial decompensation occurs, dilatation of arterioles and arteriovenous anastomoses is detected. Blood is deposited in the capillary bed. Signs of hypotension occur and blood supply to skeletal muscles deteriorates. The duration of the period is 5-15 minutes, depending on the compensatory capabilities of the body.
Paralytic stage. Complete decompensation of the condition associated with depletion of blood circulation regulation mechanisms. There is a passive expansion of capillaries, visible signs of vascular stagnation on the skin, and depression of consciousness. Hypoxia of the central nervous system organs develops. Without help, heart rhythm disturbances may occur and death.

Symptoms of collapse

The clinical picture that develops in acute vascular insufficiency changes as the disease progresses. The sympathotonic stage is characterized psychomotor agitation, anxiety, increased muscle tone. The patient is active, but is not fully aware of his actions, cannot sit or lie quietly even at the request of the medical staff, and rushes about in bed. The skin is pale or marbled, the extremities are cold, and there is an increase in heart rate.

At the vagotonic stage the patient is inhibited. He answers questions slowly, monosyllabically, and does not understand the essence of the speech addressed to him. Muscle tone decreases, disappears motor activity. The skin is pale or gray-cyanotic, earlobes, lips, and mucous membranes acquire a bluish tint. Blood pressure decreases moderately, bradycardia or tachycardia occurs. The pulse is weakly determined, has insufficient filling and tension. Decreases glomerular filtration, which causes oliguria. Breathing is noisy and rapid. Nausea, dizziness, vomiting, and severe weakness occur.

With paralytic collapse, loss of consciousness occurs, cutaneous (plantar, abdominal) and bulbar (palatal, swallowing) reflexes disappear. The skin is covered with blue-purple spots, which indicates capillary stagnation. Breathing is rare, periodic according to the Cheyne-Stokes type. Heart rate slows down to 40-50 beats per minute or less. The pulse is threadlike, blood pressure drops to critical levels. Early stages sometimes they stop without medical intervention, due to compensatory and adaptive reactions. At the final stage of the pathology, independent reduction of symptoms is not observed.

Complications

The main danger during collapse is considered to be a disruption of blood flow in the brain with the development of ischemia. At long term This disease causes dementia, dysfunction of internal organs innervated by the central nervous system. If you vomit due to unconsciousness or stupor, there is a risk of inhaling gastric contents. Hydrochloric acid in the respiratory tract causes burns of the trachea, bronchi, and lungs. Aspiration pneumonia occurs, which is difficult to treat. Absence immediate assistance at the third stage leads to the formation of pronounced metabolic disorders, disruption of the receptor systems and death of the patient. A complication of successful resuscitation in such cases is post-resuscitation illness.

Diagnostics

Diagnosis of collapse is carried out medical worker, the first to arrive at the scene of the incident: in the ICU - an anesthesiologist-resuscitator, in a therapeutic hospital - a therapist (cardiologist, gastroenterologist, nephrologist, etc.), in surgical department- surgeon . If the pathology has developed outside a healthcare facility, a preliminary diagnosis is made by the ambulance team medical care according to inspection data. Additional Methods prescribed in medical institution for the purpose of differential diagnosis. Collapse is distinguished from coma of any etiology, fainting, shock. The following methods are used:

Physical. The doctor discovers clinical signs hypotension, absence or depression of consciousness, persisting for 2-5 minutes or more. A shorter period of unconsciousness followed by its subsequent recovery is characteristic of fainting. According to the results of tonometry, blood pressure is below 90/50. There were no signs of head injury, including focal symptoms.
Hardware. Performed after stabilization of hemodynamics to determine the causes of collapse. A CT scan of the head (tumors, focal inflammatory processes), a CT scan of the abdominal cavity (pancreatitis, cholelithiasis, mechanical damage). In the presence of coronary pain, an ultrasound of the heart is performed (dilation of the chambers, birth defects), electrocardiography (signs of ischemia, myocardial infarction). Suspicion of vascular disorders is confirmed using color Doppler mapping, which makes it possible to establish the degree of patency of arteries and venous vessels .
Laboratory. During laboratory examination determine blood sugar levels to exclude hypo- or hyperglycemia. A decrease in hemoglobin concentration is detected. Inflammatory processes lead to an increase in ESR, pronounced leukocytosis, and sometimes to an increase in the concentration of C-reactive protein. With prolonged hypotension, a shift in the pH value to the acidic side and a decrease in the concentration of electrolytes in the plasma are possible.

Urgent Care

The patient in a state of collapse is placed on a horizontal surface with his legs slightly elevated. When vomiting, turn the head so that the discharge flows freely out and does not fall into the respiratory tract. The VDP is cleaned with two fingers wrapped gauze swab or a clean cloth. List of further therapeutic activities depends on the stage of collapse:

Stage of sympathotonia. Procedures aimed at relieving vascular spasm are indicated. Papaverine, dibazol, no-shpu are administered intramuscularly. To prevent hypotension and stabilize hemodynamics, use steroid hormones(dexamethasone, prednisolone). It is recommended to place a peripheral venous catheter, monitoring blood pressure and general condition of the patient.
Vagotonia And paralytic stage . To restore bcc, infusions of crystalloid solutions are carried out, to which cardiotonic agents are added, if necessary. To prevent aspiration of gastric contents during prehospital stage An airway or laryngeal mask is installed in the patient. Glucocorticosteroids, cordiamin, and caffeine are administered once in a dose appropriate to the patient's age. Pathological breathing is an indication for transfer to mechanical ventilation.

Hospitalization is carried out in the intensive care unit of the nearest specialized healthcare facility. The hospital continues therapeutic measures, an examination is prescribed, during which the causes of the pathology are determined. Provides support for vital functions of the body: breathing, cardiac activity, kidney function. Therapy is carried out aimed at eliminating the causes of a collaptoid attack.

Prognosis and prevention

Since pathology develops with decompensation serious illnesses, the prognosis is often unfavorable. Directly vascular insufficiency is relatively easy to stop, but if its underlying cause remains the same, attacks occur again. Intractable collapse leads to the death of the patient. Prevention is timely treatment pathologies that can lead to sharp fall vascular tone. Properly selected therapy for heart diseases, timely prescription of antibiotics for bacterial infections, complete detoxification in case of poisoning and hemostasis in case of injury can prevent collapse in 90% of cases.

Vascular collapse occurs in large quantity people and often leads to death. Death occurs within 5-10 minutes after loss of consciousness; if no one is nearby at this time, the victim dies. It is very important for everyone to remember the basic clinical symptoms and “harbingers” of the disease - this will help save human lives. Providing first aid does not require special skills and abilities, but is very effective.

Collapse

This emergency requiring urgent medical attention. Actually, collapse is an acute vascular insufficiency, characterized by a drop in vascular tone and a decrease in the volume of circulating blood.

The main pathogenetic effect is associated with a violation of the autonomic activity of the body, as a result of damage to the central and peripheral nervous systems:

The central nervous system, that is, the brain, includes several important centers for regulating the activity of the vascular system. These include: kernels cranial nerves, accumulation of neurons in the brain substance, hypothalamus, orbital cortex, insula, hippocampus, cingulate gyrus, amygdala. Latest Research prove that the activity of the cardiovascular system is influenced by any part of the brain. That is, if any part of the head is damaged, disorders are possible that manifest themselves in the form of bradycardia, tachycardia, hyper- or hypotension, and the like. The different directions of the manifested signs are associated with the lack of a strict specific response to a certain type of lesion.
With activity impairment peripheral part nervous system is associated with the appearance of orthostatic hypotension. This is a condition where blood pressure drops sharply when moving from a lying position to a standing position. It is observed in children and elderly people. The latter are characterized by the appearance of symptoms of cerebral circulatory disorders. Key factor The pathogenesis in this case is the pathology of the release of norepinephrine, adrenaline and renin at the right time. In this case, the necessary vasoconstriction and increase in intravascular resistance, stroke volume and heart rate do not occur. The causes of impaired neurotransmitter release are different: damage to peripheral sympathetic fibers and blocking the release of neurotransmitters. Hypotension also occurs with pathology of postganglionic sympathetic fibers, while the amount of norepinephrine in the blood is reduced even in the supine position. As a person moves to a standing position, the level of the transmitter continues to decrease.

Vascular collapse occurs when the following diseases: tumors in the occipital and parietal lobes of the brain, brain stem, ventricles. Also found in Shy-Drager syndrome and multiple sclerosis.

Symptoms

There are three periods in the development of collapse:

1. Pre-fainting. Lasts from several seconds to minutes, characterized by the appearance short-term symptoms collapse, the so-called “precursor period”. At this time, the person complains of severe headache, blurred vision, nausea, pressure in the temples, congestion in the ears, slight dizziness, weakness and discomfort in the limbs.
2. Actually fainting. The main symptom is a lack of consciousness, lasting on average about five minutes. During this period, a person experiences cyanosis of the skin and mucous membranes, a decrease in pulse, and a lack of response to painful and tactile stimuli. In severe cases, seizures occur.
3. Recovery period. At this time, a gradual restoration of consciousness occurs. Within a few seconds, the patient begins to fully orient himself in time and space.

Unfavorable signs that occur during an attack of vascular insufficiency are: shortness of breath, paroxysmal tachycardia with a frequency of more than 160 beats per minute, a decrease in heart rate less than 60 per minute, prolonged strong headache, hypotension in a supine position.

Emergency assistance

The victim needs first aid, so it is necessary to urgently call a medical team. Before her arrival, a number of mandatory instructions should be followed:

Urgently place the patient in horizontal position with raised legs. Allow air flow by unfastening buttons or ties.
Carefully bring a cotton swab moistened with the solution to your temple ammonia. If there is no reaction, gently move the cotton wool to the nasal passages. Ammonia has a stimulating effect on the respiratory and vascular centers.
At long absence consciousness (more than 2 minutes) turn the victim on his side. This is necessary to prevent aspiration of vomit or tongue during convulsions.
The patient should not be left alone until emergency medical services arrive.
After the doctors arrive, report the time of unconsciousness and any complications that have arisen (vomiting, convulsions, speech disorders, etc.). It is necessary to describe in detail possible reason the occurrence of vascular collapse, precursors (headache, nausea, fever). If a person came to his senses before the doctors arrived, you need to pay attention to the time after which the victim began to navigate, and general condition body.

Be sure to pay attention to complaints after an attack: pain in chest, shortness of breath, double vision, disturbances in speech, gait, and so on. The ambulance team fully examines the victim to identify complications: biting the tongue, injury during a fall, hidden bleeding. Be sure to pay attention to the medical history: similar cases in childhood, episodes of loss of consciousness among relatives, names of drugs used medicines, concomitant diseases.

If the victim is found to have injuries resulting from a fall, if signs of injury appear somatic organs, abnormalities in the anamnesis, repeated cases of vascular shock, pathological manifestations ECG and so on, the patient is hospitalized in a hospital.

Treatment at the hospital stage

The medical team delivers the victim to a specialized department, where a high-quality examination and diagnosis of the disease is carried out. During transportation, medications are administered to the patient. The nurse’s action algorithm is as follows:

With a significant decrease in blood pressure (systolic less than 50 mm Hg), Midodrine is administered. Begins to act within 10 minutes, maintaining positive effect up to three hours. The mechanism of action is to influence the receptors of blood vessels, which leads to their reflex narrowing. Phenylephrine, which is administered intravenously, has a similar effect. Unlike Midodrine, it begins to act immediately and retains its effect on blood vessels for up to 20 minutes. Medicines Contraindicated for pathologies of the kidneys, adrenal glands, urinary disorders, thyrotoxicosis and pregnancy.
The drug Atropine copes well with bradycardia. It is administered intravenously. A small concentration of the drug in the body can, on the contrary, reduce the heart rate, so the dose of Atropine should be selected carefully. In emergency cases, there are no contraindications for the use of the drug. Use cautiously in people with glaucoma, increased intracranial pressure, coronary disease heart disease, intestinal damage, hyperthyroidism and arterial hypertension.

If cardiac pacing is necessary, the patient is referred to cardiology department. Registration of focal brain symptoms requires specialized treatment, so the victim is transported to the neurological department. After treatment, up to 2-4 months of rehabilitation are necessary, after which complete restoration of functions occurs.

Collapse is a manifestation of acute insufficiency of the vascular system, caused by a drop in vascular tone or a decrease in the volume of circulating fluid (CVF). This symptom complex is often commonplace and familiar to many representatives adolescence, as well as people suffering vegetative-vascular dystonia. However, the pathology of this condition can lead to more serious consequences.

Mechanisms of collapse

Collapse in itself is not a disease, it is the body’s reaction to internal pathogenic factors.

There are 2 main mechanisms for the development of collapse:

1. A decrease in the tone of arterioles and venules due to the direct action of a pathogenic agent on the vascular wall or vasomotor center, which leads to an increase in capacity vascular bed and a decrease in venous inflow to the heart, a drop in blood pressure (since venous inflow largely determines subsequent systole).

2. A rapid decrease in circulating blood volume during massive blood loss. When losing less blood volume, the body copes by increasing the heart rate and spasms small vessels caused by the release of catecholamines into the blood. When the collapse develops, the data defensive reactions They are simply ineffective because the blood loss is too great.

Catecholamines (contraction hormones) - adrenaline, norepinephrine. One of the functions they perform is to mobilize the internal forces of the body and prepare it for physical work. Their dual influence on human vascular tone makes these substances an important link in the development of collapse and shock.

These mechanisms are often combined. As a result of a drop in blood pressure, blood supply to tissues is disrupted, and hypoxia (oxygen starvation) develops. Since the function of the blood flow is not only to deliver oxygen to tissues, but also to remove accumulated carbon dioxide (CO2), metabolic acidosis of the circulatory type develops, i.e., the accumulation of waste products by cells, which leads to increased permeability of the endothelium. Violations rheological properties blood (viscosity) create the prerequisites for the development DIC syndrome(disseminated intravascular coagulation) - the formation of microclots in the blood and even greater suppression of the body’s nutrition.

If help is not provided in time, death is inevitable.

Species

In medicine, there are many collapses; it would be more practical to identify the common causes that cause them:

lack of fluid;
heart pathologies;
vasodilation.

Hypovolemic collapse occurs due to excessive loss of body fluid - dehydration, blood loss (external traumatic and internal cavitary and parenchymal), as a result of which the volume of blood circulating through the vessels drops sharply.

Cardiogenic collapse develops against the background of heart valve insufficiency, acute disorder cardiac activity or a sharp decrease in cardiac output.

Vasodilation becomes the cause of vascular dysfunction in situations of severe and infectious conditions(When we're talking about about sepsis - the entry of microorganisms into the bloodstream, fibrinolytic enzymes such as streptokinase, streptodecase, which prevent normal thrombus formation, play an important role in disrupting the functionality of blood vessels), oxygen starvation, overheating, pathologies endocrine glands. Adenosine, histamine, excess kinins, improper use of medications entail an increase in resistance in the peripheral bloodstream - DIC syndrome.
Deserves special attention orthostatic collapse or orthostatic hypotension. Occurs during a sudden change in body position (usually when standing up) - the heart does not have time to respond to the increased load by increasing its own work, and due to a drop in pressure it does not reach the brain. sufficient quantity blood. The result is dizziness, darkening of the eyes. In a couple of seconds healthy person everything returns to normal, but in adolescents (whose immature cardiovascular system at this time is naturally weak) and people with weakened vascular tone may develop a fainting state.

Orthostatic hypotension is diagnosed if the following conditions occur after several minutes of standing:

blood pressure drop by 20 mm Hg. and more;
drop in diastolic pressure (lower) by 10 mm Hg. and more;
symptoms of brain tissue hypoxia (insufficient oxygen supply to brain tissue) - dizziness, darkening of the eyes, fainting.

Orthostatic hypotension is a violation of blood pressure during vertical loads or after a change in body position, and orthostatic collapse is a violation of brain perfusion and associated changes in consciousness.

Symptoms are typical for hypotonic and presyncope states:

apathy;
cold sweat;
pale skin, especially in the lip area;
weak, barely palpable pulse;
frequent shallow breathing, arrhythmias are possible.

Collapse states of the body, unlike shock ones, are characterized by the absence of an erectile (excitatory) stage - as blood pressure progressively declines, consciousness turns off.

First aid

As soon as you need emergency help, call the doctors. Until the specialists arrive, it is necessary to bring the patient to his senses as quickly as possible.

Place the victim on a hard surface, slightly raise his legs (this will increase blood flow to the head), remove his outer clothing, remove everything that can hinder movement and breathing (suspenders, belt, backpack), provide oxygen to the room. Apply ammonia solution to the patient's nose. If the victim is bleeding, you should try to stop it.

Antispasmodics and blows to the face are ineffective.

Further treatment occurs in several directions:

1. Causal - eliminating the factors that caused the collapse. Removal of poisons, elimination of hypoxia, activation sympathetic system, normalization of cardiac activity, stopping bleeding - all this will stop the deeper development of collapse.
2. Pathogenetic - replenishment of structures destroyed by pathogenic factors, return of lost functions. This is restoration of the level of arterial and venous pressure, stimulation of respiration, activation of blood circulation, administration of blood substitutes and plasma, stimulation of the central nervous system.

Only timely medical intervention can help the patient regain lost functions and return to normal.

Collapse is a complex of disorders caused by acute vascular insufficiency, which develops as a result of the action of a wide variety of pathogenic factors. The pathophysiology of various collapses is similar. Patients require immediate first aid and sometimes surgery.

Almost all of us have encountered such a painful condition as vascular collapse on own experience or from the experiences of loved ones. If collapse is accompanied by loss of consciousness, then this condition is called fainting. But quite often a collaptoid state develops against the background of preserved consciousness.

Collapse is, by definition, an acutely developing vascular insufficiency. The name "collapse" comes from the Latin word collapsus, meaning "weakened" or "fallen."

At the first signs of the development of cardiovascular collapse, first aid is necessary. This condition often leads to the death of the patient. To prevent negative consequences you should know the reasons that cause collapse and be able to
it is right to prevent them.

How does acute vascular insufficiency develop?

Collapse is characterized by a decrease in vascular tone, which is accompanied by a relative decrease in the volume of blood circulating in the body. In simple words, the vessels dilate over a short period of time, and the blood available in the bloodstream becomes insufficient for the vital blood supply important organs. The body does not have time to quickly react to changes in vascular tone and release blood from the blood depots. acute vascular insufficiency, collapse develops acutely and rapidly.

If the collapse is accompanied by a critical disruption of the blood supply to the brain, then fainting or loss of consciousness occurs. But this does not happen in all cases
collapsed state.

As collapse develops, health worsens, dizziness, paleness of the skin and mucous membranes appear, and cold sweat may occur. Breathing becomes frequent and shallow, heart rate increases, and blood pressure decreases.

Cardiovascular collapse: first aid

As a rule, collapse develops against a background of weakening of the body after serious illnesses, infections, intoxications, pneumonia, with physical and mental stress, with a decrease or increase in blood sugar levels. If a collapsing state or fainting lasts more than 1-2 minutes, then some serious illness should be suspected and an emergency doctor should be called.

First first aid in case of cardiovascular collapse and fainting should be as follows: eliminate potential dangers (electric current, fire, gas), make sure the patient has free breathing or provide it (unfasten the collar, belt, open the window), pat his cheeks and splash his face with cold water.

If such conditions occur repeatedly, their duration and frequency increase, then it is necessary to conduct a full clinical examination to determine the cause of their occurrence.